Objective To determine the effect of type D personality on depression in the elderly and investigate the role of social support and resilience between them. Methods A total of 208 elderly patients aged 60 and above admitted in the outpatient Departments of Cardiology, Neurology and Psychology of the First Medical Center of Chinese PLA General Hospital were recruited in this study. Patient health questionnaire(PHQ-9), Connor-Davidson resilience scale (CD-RISC), social support rating scale(SSRS), type D personality scale-14(DS14) and mini-international neuropsychiatric interview(MINI) were used to investigate type D personality characteristics and depression. The data was analyzed with SPSS statistics 23.0. Pearson correlation analysis was used to analyze the correlation of type D personality, resilience, social support and depression. For the correlation, process Plug-in was applied to analyze the mediating effect of social support and resilience in type D personality and depression, and Bootstrap method was adopted to test whether the mediating effect was statistically significant. Results Among the total of 208 subjects, the risk of depressive disorder of subjects with type D personality was 4.18 times higher than that of those without (95% CI 2.01-8.69). Type D personality could directly affect depressive symptoms, with a direct effect value of 3.83 (95% CI 1.60-6.06). Type D personality could regulate depression through social support and psychological resilience, with a mediating effect value of 1.92 (95% CI 0.97-3.06). Specifically, the mediating effect was mainly composed of 3 parts:the mediating effect value of type D personality-social support-depression was 0.86 (95% CI 0.24-1.73); type D personality-resilience-depression was 0.81 (95% CI 0.19-1.62), and that of type D personality-social support-resilience-depression was 0.25 (95% CI 0.05-0.55). Conclusion Type D personality is a risk factor for depression in the elderly. Its mechanism includes 2 parts, direct effect and mediating effects of social support/resilience/social support-resilience.